自身免疫与抑郁之间的关联：血清 IL-6 和 IL-17 直接影响首发抑郁症患者的 HAMD 评分。
Associations between Autoimmunity and Depression: Serum IL-6 and IL-17 Have Directly Impact on the HAMD Scores in Patients with First-Episode Depressive Disorder.
机构信息
Psychiatry Department, Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001 Shanxi Province, China.
出版信息
J Immunol Res. 2022 May 16;2022:6724881. doi: 10.1155/2022/6724881. eCollection 2022.
OBJECTIVE
The study is aimed at evaluating the immune-activation state before and after treatment in patients with first-episode depressive disorder (FDD) with evaluating the ILs and CRP levels and further clarifying the association between autoimmunity and the etiology and pathogenesis of FDD.
METHODS
We designed a case-control study. FDD patients and healthy subjects were enrolled in the FDD group and control group. Serum IL-6, IL-17, and CRP were measured before and after selective serotonin reuptake inhibitor (SSRI) therapy, as well as Hamilton rating scale for depression (HAMD) and life event scale (LES) scores. The correlations between IL-6 and IL-17 and HAMD and LES scores were analysed, and multiple linear regression analysis was performed for HAMD score.
RESULTS
40 FDD patients and 40 healthy subjects were included in the FDD and control group from October 2009 to September 2012. Before treatment, the IL-6 (28.99 ± 5.51, < 0.001) and IL-17 (41.15 ± 4.80, < 0.001) in the FDD group were significantly higher than the control group (16.84 ± 3.78 and 21.68 ± 3.72, respectively). The C-reactive protein (CRP) level in two groups was comparable ( = 0.879). After treatment, the IL-6 (18.69 ± 5.07, < 0.001) and IL-17 (30.67 ± 3.47, < 0.001) levels and HAMD scores (6.73 ± 4.15) in the FDD group were significantly decreased than before treatment ( < 0.001, respectively). CRP level was slightly increased after treatment without statistically significant ( = 0.239). The HAMD score correlated with IL-6 ( = 0.638, < 0.001) and IL-17 ( = 0.927, < 0.001); the total LES and negative LES also correlated with IL-6 ( = 0.226, < 0.05) ( = 0.366, <0.001) and IL-17 ( = 0.348, < 0.001) ( = 0.493, < 0.001). Multiple linear regression analysis showed that both of the IL-6 and IL-17 had direct impact on HAMD score.
CONCLUSION
The autoimmunity status was overactivated in FDD patients, and serum IL-6 and IL-17 levels had direct impact on the HAMD score. Patients who experienced more negative life events had higher activation level of autoimmunity status and HAMD scores, and serum IL-6 and IL-17 levels can be decreased by SSRI treatment.
目的
通过评估首发抑郁障碍（FDD）患者治疗前后的免疫激活状态，检测白细胞介素（IL）-6、IL-17 和 C 反应蛋白（CRP）水平，进一步阐明自身免疫与 FDD 的病因和发病机制之间的关系。
方法
我们设计了一项病例对照研究。将 FDD 患者和健康受试者纳入 FDD 组和对照组。在选择性 5-羟色胺再摄取抑制剂（SSRI）治疗前后测量血清 IL-6、IL-17 和 CRP，以及汉密尔顿抑郁量表（HAMD）和生活事件量表（LES）评分。分析了 IL-6 和 IL-17 与 HAMD 和 LES 评分之间的相关性，并对 HAMD 评分进行了多元线性回归分析。
结果
2009 年 10 月至 2012 年 9 月，共纳入 40 例 FDD 患者和 40 例健康受试者。治疗前，FDD 组的 IL-6（28.99 ± 5.51，<0.001）和 IL-17（41.15 ± 4.80，<0.001）水平明显高于对照组（分别为 16.84 ± 3.78 和 21.68 ± 3.72）。两组的 CRP 水平相当（=0.879）。治疗后，FDD 组的 IL-6（18.69 ± 5.07，<0.001）和 IL-17（30.67 ± 3.47，<0.001）水平以及 HAMD 评分（6.73 ± 4.15）均较治疗前明显下降（均<0.001）。CRP 水平在治疗后略有升高，但无统计学意义（=0.239）。HAMD 评分与 IL-6（=0.638，<0.001）和 IL-17（=0.927，<0.001）呈正相关；总 LES 和负性 LES 也与 IL-6（=0.226，<0.05）（=0.366，<0.001）和 IL-17（=0.348，<0.001）（=0.493，<0.001）呈正相关。多元线性回归分析显示，IL-6 和 IL-17 均直接影响 HAMD 评分。
结论
FDD 患者的自身免疫状态过度激活，血清 IL-6 和 IL-17 水平直接影响 HAMD 评分。经历更多负性生活事件的患者，其自身免疫状态和 HAMD 评分的激活水平更高，SSRI 治疗可降低血清 IL-6 和 IL-17 水平。
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